Dual Tragedies: Domestic Homicide-Suicides with a Firearm

Introduction

On average, more than once per day in the United States, a tragedy occurs where a perpetrator kills an intimate partner, and then dies by suicide themself.¹Violence Policy Center, “American Roulette Murder-Suicide in the United States,” editions 4–8, https://vpc.org/revealing-the-impacts-of-gun-violence/murder-suicide/. A five-year average was developed using 2011, 2014, 2017, 2019, and 2021 data. An average of 187 intimate partner murder-suicide incidents occurred over six months, an estimated 374 annually. Of these incidents, 93 percent involved a gun, and 95 percent had women killed by their male partners.²Violence Policy Center, “American Roulette Murder-Suicide in the United States,”  editions 4–8, https://vpc.org/revealing-the-impacts-of-gun-violence/murder-suicide/. A five-year average was developed using 2011, 2014, 2017, 2019, and 2021 data. These tragedies often include children, family members, and friends.³Sierra Smucker, Rose E. Kerber, and Philip J. Cook, “Suicide and Additional Homicides Associated with Intimate Partner Homicide: North Carolina 2004–2013,” Journal of Urban Health 95, no. 3 (June 2018): 337–43, https://doi.org/10.1007/s11524-018-0252-8. Despite the devastation and immeasurable impact, these events garner little public attention and recognition as a frequent form of gun violence.

To explore intimate partner homicide-suicide, Everytown for Gun Safety Support Fund conducted focus groups with 43 survivors. They include mothers of abused women who were murdered, aunts who became legal guardians of the children of parents who died by IPHS, adults who witnessed the death of both parents during childhood, and others who were affected by these tragedies. Our goal was to better understand their experiences of intimate partner violence (IPV) with a firearm, the circumstances around the incident, the shooter’s access to firearms, traumatic impacts, interventions, and posttraumatic growth. 

The dual tragedies of intimate partner homicide-suicide often occurred amid warning signs and risk factors. In the focus groups, all survivors of IPHS identified one or more of these 11 common risk factors: 

1. Access to a firearm
2. Previous abuse in the relationship, such as verbal, emotional, or physical abuse
3. Threats against children and family members
4. History of traumatic events (e.g., childhood exposure to violence)
5. Suicidal behaviors, such as suicidal ideation, suicide attempts, and threats of suicide
6. Divorce or separation
7. Jealousy
8. Stalking
9. Abuse through technology
10. Substance misuse
11. Social isolation

In the aftermath of these incidents, survivors and family members must cope with their own trauma responses; tend to the needs of others, including children; and navigate support services and court systems. Families are fractured, and communities struggle to understand why and how these tragedies could occur.

Access to a Gun: The Centerpiece of Dual Tragedies

Access to a gun is the centerpiece of the dual tragedies of intimate partner homicide and suicide. Research shows that approximately 90 percent of gun suicide attempts end in death,⁴Andrew Conner, Deborah Azrael, and Matthew Miller, “Suicide Case-Fatality Rates in the United States, 2007 to 2014: A Nationwide Population-Based Study,” Annals of Internal Medicine 171, no. 12 (2019): 885–95, https://doi.org/10.7326/m19-1324. and access to a gun makes it five times more likely that an abusive male partner will kill his female victim.⁵Jacquelyn Campbell et al., “Risk Factors for Femicide in Abusive Relationships: Results from a Multisite Case Control Study,” American Journal of Public Health 93, no. 7 (July 2003): 1089–97, https://doi.org/10.2105/ajph.93.7.1089.  And while IPHS is generally characterized by many precipitating factors and a history of abuse, one of the most common factors in these incidents is that the offender had access to a gun and used it.⁶April M. Zeoli, “Multiple Victim Homicides, Mass Murders, and Homicide-Suicides as Domestic Violence Events,” Battered Women’s Justice Project, November 2018, https://www.preventdvgunviolence.org/multiple-killings-zeoli.pdf. 

Impulsivity and Easy Access to Guns

In the focus groups, even though there was often long-term intimate partner violence and other risk factors leading up to the incident, survivors consistently discussed the impulsive nature of IPHS, facilitated by easy access to a firearm. The “knee-jerk reaction” of carrying out IPHS resonated with survivors in the focus groups as they described the moments before the incident. A survivor whose daughter was killed by their partner stated, 

Another survivor discussed how her partner died by suicide with an easily accessible gun:

Where was the gun stored?

Thirty-two percent of survivors in the focus groups stated that the gun used was easily accessible and stored unsecured. As with this incident, guns were easily accessible in a nightstand, under the mattress, in the car, or unsecured at a family member’s house. Suicidal crises are often very brief, and access to a gun in a moment of crisis may be the difference between life and death for an individual; in the case of IPHS, easy access to a gun could mean the difference between life and death for multiple people. 

Gaps in Gun Safety Policies and Implementation Failures

Many survivors in the focus groups revealed that, prior to the incident, offenders threatened family members and the victim that they would use a firearm for IPHS. In addition, the survivors highlighted that the perpetrator was a danger to themselves or others, describing behaviors such as suicidal ideation, stalking, and abuse within the relationship between the victim and the perpetrator. In response to these threats and actions, family members took various steps, including contacting their local police department to remove access to a gun, obtaining restraining orders, and seeking support from lawyers. However, survivors and their families faced a number of challenges in the form of difficulty accessing legal interventions and the judiciary and law enforcement’s failure to enforce laws. These challenges ultimately enabled abusers to continue having access to guns, leading to devastating effects. 

A mother whose daughter was killed described the multiple failures among institutions and support services: 

Laws that disarm abusers do not implement themselves. Mothers, partners, and family members in the focus groups spoke about the various “red flags” raised and the lack of adequate action from service providers and court systems to guard the safety of the victim and their children. 

Challenges Accessing Legal Interventions

In response to firearm threats and dangerous behaviors, family members attempted to remove access to a gun through an extreme risk protection order (ERPO) and obtain a domestic violence restraining order (DVRO), which may include several vital protections, such as ordering the abuser to stay away from the survivor and housing and child custody provisions. However, when survivors sought protection through a DVRO or an ERPO, they were often met with a myriad of challenges, such as stigmatization from law enforcement and the courts and bureaucratic barriers. For example, a survivor whose partner attempted to kill her before he died by suicide described the difficulties in obtaining a DVRO:

Research shows that states that prohibit abusers subject to DVROs from possessing firearms have seen a 13 percent reduction in intimate partner firearm homicide rates,⁷April Zeoli et al., “Analysis of the Strength of Legal Firearms Restrictions for Perpetrators of Domestic Violence and Their Associations with Intimate Partner Homicide,” American Journal of Epidemiology 187, no. 11 (November 2018): 2365–71, https://doi.org/10.1093/aje/kwy174. and studies in Indiana and Connecticut estimate that one suicide is prevented for every 10 to 11 firearm removals under Extreme Risk laws.⁸ Aaron J. Kivisto and Peter Lee Phalen, “Effects of Risk-Based Firearm Seizure Laws in Connecticut and Indiana on Suicide Rates, 1981–2015,” Psychiatric Services 69, no. 8 (August 2018): 855–62, https://doi.org/10.1176/appi.ps.201700250. The recent US Supreme Court decision in United States v. Rahimi⁹Everytown for Gun Safety, “United States v. Rahimi,” https://www.everytown.org/rahimi-scotus/. is crucial for victims, survivors of IPV, and their families as it ruled that the federal law prohibiting domestic abusers subject to DVROs from possessing guns is constitutional under the Second Amendment. This decision makes it clear that guns do not belong in the hands of domestic abusers. 

Histories of Stalking and Loopholes in the Law

Ten percent of survivors in the focus groups stated that perpetrators engaged in stalking behaviors before the homicide-suicide or attempted homicide-suicide. A survivor whose mother died by IPHS discussed this:

Violent and harassing stalking behaviors often occur alongside physical, emotional, and psychological abuse—contributing to fear of future serious harm or death.¹⁰Mindy B. Mechanic, Terri L. Weaver, and Patricia A. Resick, “Intimate Partner Violence and Stalking Behavior: Exploration of Patterns and Correlates in a Sample of Acutely Battered Women,” Violence and Victims 15, no. 1 (Spring 2000): 55–72, https://doi.org/10.1891/0886-6708.15.1.55. Stalking is a strong risk factor for intimate partner homicide: one study found that 76 percent of intimate partner homicides and 85 percent of attempted homicides of women were preceded by at least one incident of stalking in the year before the attack.¹¹ Judith MacFarlane et al., “Stalking and Intimate Partner Femicide,” Homicide Studies 3, no. 4 (November 1999): 300–316, https://doi.org/10.1177/10887679990. Yet federal law only bars those convicted of felony stalking from obtaining a firearm—not those with misdemeanor stalking convictions. Fewer than half of states have closed this loophole by either classifying stalking as a felony offense or by extending prohibiting offenses for accessing firearms to include specified misdemeanors.¹²As of May 2024, 21 states prohibited people with stalking convictions from having firearms. Everytown for Gun Safety Support Fund, “Everytown Gun Law Rankings: Which States Prohibit People with Stalking Convictions from Having Firearms?,” accessed May 29, 2024, https://everytownresearch.org/rankings/law/stalker-prohibitor/.

Failure to Block Gun Access from Prohibited Perpetrators

Even when survivors had access to and sought protections and petitioned a court for an order to temporarily prevent someone in crisis from accessing guns, the judicial system and law enforcement frequently failed to protect survivors and to enforce lifesaving laws, including ensuring that a perpetrator prohibited from having guns did not have access to them. In our focus groups, survivors stated that nearly 25 percent of the perpetrators were prohibited by law from possessing a firearm,¹³Everytown for Gun Safety has not independently confirmed the prohibited status of the perpetrators. due to reasons including being under a domestic violence restraining order, having been convicted of a felony or misdemeanor domestic violence crime, or having certain mental health histories. A survivor whose sister and nephew died in a family annihilation followed by suicide discussed this:

This family continues to struggle with the loss of their loved ones, and the question of “how did he access a gun?” remains. The reality is that far too often, people who are legally prohibited from having firearms are able to evade a background check and purchase firearms with no questions asked. Each year, on average, at least one in eight prohibited purchasers of firearms who are denied the purchase through a background check are denied due to prohibiting domestic violence histories.¹⁴US Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, “Publications & Products: Background Checks for Firearm Transfers,” https://bit.ly/2F4vMYw. Data on federal- and state-level denials were obtained from the BJS reports for the years 1999–2010 and 2012–2020. Local-level denials were available and included only for the years 2012, 2014–2018, and 2020 from the BJS reports. Data for the years 2011 and 2021 were obtained by Everytown for Gun Safety from the FBI directly. Though the majority of the transactions and denials reported by the FBI and BJS are associated with a firearm sale or transfer, a small number may be for concealed-carry permits and other reasons not related to a sale or transfer. Totals include both those who are prohibited due to a misdemeanor crime of domestic violence (MCDV) conviction and those who are denied due to restraining or protection orders for domestic violence. According to survivors in the focus groups, in too many cases, no one ensured that the centerpiece of this tragedy—the gun—was removed when the perpetrator became legally prohibited from having it. 

Risk Factors and Impact of Intimate Partner Homicide-Suicide

There is no excuse for abuse. Recognizing the risk factors leading up to an IPHS incident is critical in order to identify the events that enable these unimaginable tragedies and to understand what could have prevented them. We adapted a model for looking at risk factors that contribute to violence and victimization at the individual, relationship, community, and societal levels. This is called the socio-ecological model.¹⁵Developmental psychologist Urie Bronfenbrenner originally theorized an ecological model to examine human development. See Urie Bronfenbrenner, “Ecological Systems Theory,” American Psychological Association, 2000, http://dx.doi.org/10.1037/10518-046.

Individual-Level Factors

Various individual-level factors increase the risk of a person becoming a victim or perpetrator of violence. Note, however, that perpetrating abuse is never justified, regardless of the circumstances in a person’s life. Focus group findings on individual-level factors were supported by research showing that exposure to violence during childhood is a risk factor for experiencing and perpetrating IPV in adulthood.¹⁶Diana Gil-González et al., “Childhood Experiences of Violence in Perpetrators as a Risk Factor of Intimate Partner Violence: A Systematic Review,” Journal of Public Health 30, no. 1 (January 2008): 14–22, https://doi.org/10.1093/pubmed/fdm071; Angela J. Narayan et al., “The Legacy of Early Childhood Violence Exposure to Adulthood Intimate Partner Violence: Variable- and Person-Oriented Evidence,” Journal of Family Psychology 3, no. 7 (2017): 833–43, https://doi.org/10.1037/fam0000327; Margot Shields et al., “Exposure to Family Violence from Childhood to Adulthood,” BMC Public Health 20, no. 1673 (2020), https://doi.org/10.1186/s12889-020-09709-y. Such violence can include physical abuse, emotional abuse, neglect, witnessing parental IPV, and a history of suicidal behavior. A survivor discusses how exposure to violence played a role before the incident:

Survivors also shared that intimate partner violence between their parents led to their own aggressive and violent behaviors into adulthood. Moreover, such exposure and trauma during childhood also led survivors down a path of being in abusive relationships. For example, one focus group participant stated that her daughter died by IPH, and while the survivor was pregnant with her now-deceased daughter, the survivor’s mother also died by IPHS. This survivor discussed the impact on her daughter:

Exposure to the dual tragedies of IPHS experienced by her mother impacted the daughter throughout her life as she experienced trauma, feelings of guilt, and unhealthy relationships. Trauma from witnessing or experiencing abuse can be passed down across generations, a cycle called intergenerational trauma. Additionally, children who are exposed to multiple forms of violence—such as suicide, homicide, and IPV—are more likely to exhibit higher levels of distress and experience a greater risk of depression, anxiety, and PTSD.¹⁷David Finkelhor et al., “Polyvictimization: Children’s Exposure to Multiple Types of Violence, Crime, and Abuse,” National Survey of Children’s Exposure to Violence 39 (2011): 24–34, https://scholars.unh.edu/ccrc/25/.

Substance misuse was another prevalent individual-level risk factor. Focus group participants described substance misuse as both a risk factor leading up to the tragedies and a coping strategy. One survivor whose mother was killed by intimate partner homicide and whose father died by suicide stated,

This survivor witnessed her father’s substance misuse and alcohol dependence and their factoring into her mother’s abuse. Twenty-four percent of survivors and families of IPHS victims stated that substance misuse or alcohol dependence was a circumstance prior to the incident. This finding aligns with previous studies: substance misuse and alcohol dependence are a risk factor for suicide and IPV, either as a victim or perpetrator.¹⁸Deborah M. Capaldi et al., “A Systematic Review of Risk Factors for Intimate Partner Violence,” Partner Abuse 3, no. 2 (April 2012): 231–80, https://doi.org/10.1891/1946-6560.3.2.231; Yari Gvion and Yossi Levi-Belz, “Serious Suicide Attempts: Systematic Review of Psychological Risk Factors,” Frontiers in Psychiatry 9 (March 6, 2018), https://doi.org/10.3389/fpsyt.2018.00056. In fact, one study found that nearly 38 percent of IPHS perpetrators who were tested for alcohol at the time of the incident tested positive.¹⁹Joseph E. Logan, Allison Ertl, and Robert Bossarte, “Correlates of Intimate Partner Homicide among Male Suicide Decedents with Known Intimate Partner Problems,” Suicide and Life-Threatening Behavior 49, no. 6 (June 12, 2019): 1693–706, https://doi.org/10.1111/sltb.12567.

Joiner’s Theory of Suicide

While studies have focused on the previous mental health and substance misuse histories of people who died by IPHS, little is known about their previous suicidal behaviors, such as suicidal ideation, attempted suicide, and threats of suicide; they were present for nearly 25 percent of IPHS perpetrators. A survivor of attempted IPHS described the suicidal behaviors of her partner:

For this survivor, her husband threatened suicide multiple times before the incident, especially during stressful events. Suicidal ideation and attempts are connected with other risk factors, such as relationship-level issues, financial stressors, poverty, and lack of health care. These factors make up Thomas Joiner’s three primary components of suicide:²⁰Thomas Joiner, Why People Die by Suicide (Cambridge, MA: Harvard University Press, 2005).

• Perceived burdensomeness, such as feeling that one’s partner or family would be happier or better off without them.
• Thwarted belongingness, such as feeling isolated and disconnected from others and social environments.
• A build-up of lethality and fearlessness through the loss of fear of death and self-harm and suicide attempts.

Survivors of attempted IPH recalled such feelings among their partners. Simultaneously, a common aspect of intimate partner violence is that the abusive partners ensured that their victims were disconnected from family and social support networks. Abusive partners would also make the victim feel like a burden due to economic dependence and by lowering their self-esteem.

Relationship-Level Factors

In the focus groups, there were also various relationship-level factors present before the IPHS  incident. These factors include unhealthy family relationships, jealousy, possessiveness, and divorce or separation. Many of the participants who referenced divorce or separation also discussed the challenges of seeking custody of the children they shared with the perpetrator. A survivor whose daughter was killed in a homicide-suicide explained, 

In this tragedy, separation was a key factor leading to the father’s fatal actions. Separation between partners also increases the risk of lethality for the woman.²¹Kathryn J. Spearman et al., “Firearms and Post‐separation Abuse: Providing Context behind the Data on Firearms and Intimate Partner Violence,” Journal of Advanced Nursing 80, no. 4 (2024): 1484–96, https://doi.org/10.1111/jan.15933. In the focus groups, for nearly 50 percent of survivors, separation or divorce was a circumstance leading up to the incident. Research also shows that parental IPV and a perpetrator’s history of suicidal behaviors are both risk factors for child homicides.²²Vivian Lyons et al., “Risk Factors for Child Death During an Intimate Partner Homicide: A Case-Control Study,” Child Maltreatment 26, no. 4 (2021):, 356–62, https://doi.org/10.1177/1077559520983901. Barriers to safety following a separation can turn deadly as women negotiate family court and co-parenting arrangements, navigate coercive control and tactics such as stalking and technological harassment, and face economic barriers to safety.²³Kathryn Spearman et al., “Addressing Intimate Partner Violence and Child Maltreatment: Challenges and Opportunities,” Handbook of Child Maltreatment (2022): 327–49, https://doi.org/10.1007/978-3-030-82479-2_16; Kathyrn Spearman, Jennifer Hardesty, and Jacquelyn Campbell, “Post‐separation Abuse: A Concept Analysis,” Journal of Advanced Nursing 79, no. 4 (2023): 1225–46, https://doi.org/10.1111/jan.15310.

Prior abuse by the perpetrator served as another risk factor for homicide-suicides.²⁴Bernie Auchter, “Men Who Murder Their Families: What the Research Tells Us,” NIJ Journal 266 (2010). In fact, 59 percent of victims or survivors in the focus groups endured short- and long-term abuse before the incident. A survivor recalled the long-term abuse by her father before the homicide-suicide incident that killed both her parents: 

Survivors in the focus groups echoed these experiences of threat with a firearm. Previous studies on intimate partner homicides have found that perpetrators had feelings of jealousy,²⁵Laura Johnson, “Jealousy as a Correlate of Intimate Partner Homicide-Suicide versus Homicide-Only Cases: National Violent Death Reporting System, 2016–2020,” Suicide and Life-Threatening Behavior, March 30, 2024, https://doi.org/10.1111/sltb.13076. monitored victims’ behaviors through the use of technology, and expressed attitudes of ownership and possessiveness.²⁶Jane Koziol-Mclain et al., “Risk Factors for Femicide-Suicide in Abusive Relationships: Results from a Multisite Case Control Study,” Violence and Victims 21, no. 1 (February 1, 2006): 3–21, https://doi.org/10.1891/vivi.21.1.3. Multiple focus group participants shared that offenders stated before the incident, “If I can’t have you, no one can.” These behaviors were also compounded by repeated breakups. Support services and interventions on the relational level should acknowledge the heightened risk when a person is ending an abusive relationship. 

In addition, existing stigmas in society around intimate partner violence and suicide can result in survivors’ hesitance to speak about the tragedy with family members and friends. One woman whose partner died by suicide after he attempted to take her life described the impact on some of her relationships, 

As people grapple with pain, conflict, stigma, and trauma, relationships can become strained, fractured, and end. “Blame, avoidance, and a lot of silence” can produce feelings such as anger and guilt that make it difficult to cope in the aftermath. Silence surrounding the tragedy can create barriers to healing and accessing support services.

Community-Level Factors

Various community factors can increase or decrease the likelihood of someone experiencing or perpetrating intimate partner violence. Research has shown that community risk factors for IPV are high rates of violence and crime, limited support services, social isolation from community residents, and weak community sanctions against IPV—such as the unwillingness of neighbors and law enforcement to intervene in violent situations.²⁷Capaldi et al., “A Systematic Review of Risk Factors for Intimate Partner Violence.”

Rural residents have less access to support services such as local domestic violence shelters or community-based organizations. Rural survivors in the focus groups experienced less effective responses from law enforcement compared to those who lived in urban communities. And even when support services were accessible, they were limited. For example, a rural survivor of attempted IPHS stated that when her husband became verbally abusive, she contacted a local domestic shelter in her community, which told her, “Well, you don’t meet the criteria to leave with your kids,” without offering other resources or options to exit the abusive relationship. Research has shown that rural women are nearly twice as likely to be turned away from services because of inadequate staffing and a limited number of programs for survivors.²⁸Radha Iyengar and Lindsay Sabik, “The Dangerous Shortage of Domestic Violence Services,” Health Affairs 28,  Supplement 1 (January 2009): w1052–65, https://doi.org/10.1377/hlthaff.28.6.w1052. In addition, long response times from law enforcement prevent survivors from reporting. A mother who constantly told her daughter to call the police if she felt unsafe stated,

In these experiences, social isolation within one’s community became a barrier to seeking help and receiving effective response from law enforcement. Research has shown that people who reported limited social connections in a community experienced higher rates of IPV,²⁹Elizabeth Schreiber and Emily Georgia Salivar, “Using a Vulnerability-Stress-Adaptation Framework to Model Intimate Partner Violence Risk Factors in Late Life: A Systematic Review,” Aggression and Violent Behavior 57 (2021): 101493. and the focus group survivors stated that this influenced the lack of intervention from community members. A survivor who described the death of her neighbor by IPHS stated, “He [the perpetrator] had been very abusive to his wife and the kids. . . . Our whole neighborhood was watching what was going on behind a closed door.” Intimate partner violence should be a community-level concern, and neighborhood bystander intervention and local community-based resources can interrupt harmful situations. Such interventions also help those at risk to access services, heal, and connect with a supportive community—leading to safety. 

Survivors discussed the importance of such social support as communities navigate collective trauma following the tragedies: feelings of hopelessness, hypervigilance, and fear. Such exposure of trauma can also increase the risk of future violence in the community. A survivor whose brother and mother were shot and killed discussed the importance of community support during a traumatic event:

Social support as a protective factor can reduce negative psychological symptoms, such as self-harm and PTSD, and promote post-trauma resilience and recovery.³⁰Brooke Feeney and Nancy Collins, “A New Look at Social Support: A Theoretical Perspective on Thriving through Relationships,” Personality and Social Psychology Review 19, no. 2 (August 14, 2014): 113–47, https://doi.org/10.1177/1088868314544222; Casey Calhoun et al., “The Role of Social Support in Coping with Psychological Trauma: An Integrated Biopsychosocial Model for Posttraumatic Stress Recovery,” Psychiatric Quarterly 93, no. 4 (October 5, 2022): 949–70, https://doi.org/10.1007/s11126-022-10003-w. Healing happens when members of the community acknowledge the impact of the tragedy, collectively mourn, and create pathways to resources and social support for all individuals affected.

Societal-Level Factors

While survivors experienced stigma from family members, stigmatization was also prevalent at the societal level. Traditional gender norms on masculinity and femininity, racial discrimination, and sexism are embedded within societal factors that contribute to IPHS—and, in turn, prevent survivors from seeking intervention or mental health support services and reporting their abuse. 

The societal perception of IPV often revolves around the belief that partner abuse is provoked or that IPV survivors willingly stay in abusive situations. For example, one survivor stated that when she attended her court hearing for a DVRO, “The judge asked me if I deserved to be shot.” This survivor later stated, “I’m a BIPOC woman, Black, white, and Native. . . . My perpetrator was white, so of course the system took his side and made him the victim.” Dismissal of her IPV experience negatively impacted the implementation of laws that prohibit abusers’ access to guns. At a time when she faced a heightened risk, the system failed her. 

The pervasiveness of self-blame and shame accompanying IPV may lead to deadly consequences and a culture of silence. A survivor of family annihilation murder-suicide discusses the impact of being silenced:

Survivors anticipate the stigma they would endure from responders such as law enforcement, healthcare providers, and others.³¹Nicole M. Overstreet and Diane M. Quinn, “The Intimate Partner Violence Stigmatization Model and Barriers to Help-Seeking,” Basic and Applied Social Psychology 35, no. 1 (January 1, 2013): 109–22, https://doi.org/10.1080/01973533.2012.746599. As a result, survivors are discouraged from reporting their abuse or seeking interventions and protections, often downplaying the situation. For Black and Latinx women in the focus groups, they were often blamed for their abuse due to racial and gender-based stereotypes of promiscuity. In addition, perceived submissiveness among Asian American and Native American women led to a dismissal of their IPV experiences. 

While shame, stigma, and fear can limit women’s engagement with health services and the judicial system, focus group participants also discussed the stigma that men experienced when seeking mental healthcare services. Survivors mentioned various short- and long-term interventions that men sought, such as therapy from community-based organizations and visiting state mental health hospitals and psychiatric treatment centers. However, when men sought it, that care felt short. A survivor whose brother died by suicide following family annihilation describes the mental health care his brother received:

Men in the United States represent 87 percent of firearm suicide victims and are nearly seven times more likely than women to die by firearm suicide.³²Centers for Disease Control and Prevention, National Center for Health Statistics, WONDER Online Database, Underlying Cause of Death. A yearly average was developed using five years of the most recent available data: 2018 to 2022. White defined as non-Latinx origin. Yet men are less likely to seek help for mental health difficulties.³³Ilyas Sagar-Ouriaghli et al., “Improving Mental Health Service Utilization among Men: A Systematic Review and Synthesis of Behavior Change Techniques within Interventions Targeting Help-Seeking,” American Journal of Men’s Health 13, no. 3 (May 2019): 155798831985700, https://doi.org/10.1177/1557988319857009. Why is this? Research has shown that men’s help-seeking behaviors for mental health support such as depression are influenced by societal masculinity norms such as being strong, self-reliant, and in control, and avoiding their emotions.³⁴Silvia Krumm et al., “Men’s Views on Depression: A Systematic Review and Metasynthesis of Qualitative Research,” Psychopathology 50, no. 2 (March 11, 2017): 107–24, https://doi.org/10.1159/000455256. And when men do seek help, providers may underestimate their needs and miss or misdiagnose their psychological issues because of the providers’ own gender biases.³⁵ Paul Sharp et al., “‘People Say Men Don’t Talk, Well That’s Bullshit’: A Focus Group Study Exploring Challenges and Opportunities for Men’s Mental Health Promotion,” PLoS One 17, no. 1 (January 21, 2022), https://doi.org/10.1371/journal.pone.0261997. As a result, the pressures to conform to these norms discourage men from seeking support, stigmatize their help-seeking behaviors, influence their silence, and may lead to unhealthy coping strategies such as substance misuse. Destigmatizing men’s mental health challenges and help-seeking as well as understanding how masculinity norms prevent seeking support is critical to preventing suicide and disrupting risk factors for IPHS. 

In the Aftermath of IPHS

All survivors in this study experienced trauma, which refers to the lasting adverse effects of an event or a culmination of a series of events. Trauma’s impact is beyond measure—rippling through families and communities. Research shows that people who experienced threats with a gun during incidents of domestic violence had more psychological symptoms than women who experienced other IPV victimization, such as mental, emotional, and sexual types of abuse.³⁶Tami P. Sullivan and Nicole H. Weiss, “Is Firearm Threat in Intimate Relationships Associated with Posttraumatic Stress Disorder Symptoms among Women?,” Violence and Gender 4, no. 2 (June 2017): 31–36, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5467129/.

The initial impact of IPHS affected survivors’ decision-making processes and how they coped with trauma. Families whose loved ones died by IPHS immediately stepped into caretaker roles for surviving children and family members, while navigating news reporters as well as the criminal justice system to ensure justice. Some survivors became immobilized by grief and trauma. A survivor whose daughter died by IPHS discussed the initial impact: 

Survivors in the focus groups described similar responses in the incident’s initial aftermath: shock, disbelief, inability to go to work or school or to tend to necessary functions like eating, sleeping, and other daily activities. Additionally, survivors themselves had experiences of suicidal ideation and attempts. A survivor whose daughter died by domestic violence with a firearm reported,

The impact of the incident, with the compounding trauma from homicide and suicide, rippled through this family as they struggled to cope. Few studies have explored the effects of gun violence exposure on suicidal behavior. However, limited research shows that such exposure to gun violence is associated with lifetime suicidal behaviors and thoughts.³⁷Daniel Semenza et al., “Gun Violence Exposure and Suicide among Black Adults,” JAMA Network Open 7, no. 2 (2024). For the prevention of suicidality and suicide risk, we need to understand how exposure to traumatic events—especially when there are multiple deaths and traumas from one incident—serves as a risk factor.

Children as IPHS Witnesses and Victims

The impact of IPHS-related trauma can manifest differently across all stages of our lives. During early childhood, exposure to domestic violence incidents can lead to a delay in social and emotional skill development in addition to early trauma.³⁸Jack Shonkoff et al., “The Lifelong Effects of Early Childhood Adversity and Toxic Stress,” Pediatrics 129, no. 1 (2012), https://doi.org/10.1542/peds.2011-2663. Moreover, direct and indirect exposure to firearm violence among children and adolescents can lead to posttraumatic symptoms and acute stress and affect the emotional well-being of young people throughout their lives.³⁹Heather Turner et al., “Gun Violence Exposure and Posttraumatic Symptoms among Children and Youth,” Journal of Traumatic Stress 32, no. 6 (2019): 881–89. In the focus groups, children were witnesses in 43 percent of the IPHS incidents and were killed in 16 percent of these incidents. Other children had witnessed long-term abuse and were directly impacted by the deaths of mother, father, siblings, and others. A survivor of an attempted homicide-suicide describes the impact the incident had on her children: 

These traumatic impacts on children were shared throughout the focus groups. Survivors discussed that children experienced anxiety, depression, suicidal ideation, behavioral challenges, self-harm, academic challenges, school avoidance, and substance misuse. Family members also described feelings of isolation among children in schools as their peers did not interact with them.  Seeking therapy and social and familial support played critical roles in healing for child survivors as they coped with these tragedies.

Support Services and Interventions

Focus group participants noted that, prior to the homicide-suicide, victims, survivors, and perpetrators sought many types of interventions and support services. These ranged from telling family and friends about the abuse and seeking therapy, to legal interventions. Participants spoke about the lack of adequate action and support from service providers and consequences from the legal system, despite the many actors involved that are intended to guard the safety of the victim and their children. 

Survivors and family members who sought counseling described the lack of trauma-informed care. Survivors also pointed out the frequent inability of service providers to identify those at a higher risk for suicide, such as being a veteran or having previous suicide attempts. A survivor whose family members died by family annihilation homicide-suicide discussed suicidal ideation and direct threats the perpetrator had told his psychiatrist about prior to the incident:

Healthcare providers have the opportunity to put time and space between a person contemplating suicide and access to lethal means. Roughly two in three Americans who attempt suicide visit a healthcare professional in the month before an attempt.⁴¹Brian K. Ahmedani et al., “Racial/Ethnic Differences in Health Care Visits Made before Suicide Attempt across the United States,” Medical Care 53, no. 5 (May 2015): 430–35, https://doi.org/10.1097/MLR.0000000000000335. Mental health providers should be educated on the prevalence of suicides in their communities and those at higher risk for suicides. 

Focus group participants also discussed the difficulty—as a survivor of intimate partner violence with a firearm—in accessing support services such as mental health services. Stereotypes about survivors or victims of IPV can play a role in defining the “ideal” victim. A survivor whose daughter was killed discussed this:

The term “perfect victim” of domestic violence reflects decades of research showing that the ideal victim most likely to receive support is weak, white, middle-class, and in a heterosexual relationship.⁴²Nils Christie, ”The Ideal Victim,” in From Crime Policy to Victim Policy: Reorienting the Justice System, ed. Ezzat A. Fattah (London: Palgrave Macmillan UK, 1986), https://doi.org/10.1007/978-1-349-08305-3_2, 17–30. IPV survivors, particularly people of color, often fear they will not receive support if they seek help.⁴³Nicole M. Overstreet and Diane M. Quinn, “The Intimate Partner Violence Stigmatization Model and Barriers to Help-Seeking,” Basic and Applied Social Psychology 35, no. 1 (January 1, 2013): 109–22, https://doi.org/10.1080/01973533.2012.746599. Focus group participants stated that when they do seek help, it is a challenge to obtain mental health services that are culturally responsive and providers who are aware of their community’s experience with gun violence. A survivor who was shot by their partner stated, 

Such challenges resonated with focus group participants as they sought identity-responsive therapy. This survivor’s multiracial identity was central to her experience as a gun violence survivor. As a result, peer support networks and joining the gun violence prevention movement became central to her healing and posttraumatic growth. 

Recommendations

There are several ways to help prevent future dual tragedies of intimate partner homicide-suicide. The following recommendations for action can create opportunities for awareness, intervention, and prevention. 

1. Education on 11 risk factors for intimate partner homicide-suicide: Throughout the focus groups, 11 common risk factors emerged that showed the victim(s) of the homicide-suicide was in danger and the perpetrator of the homicide-suicide was also in danger. Survivors and perpetrators navigate complex systems for intervention and support, including victim services, substance misuse services, law enforcement, and the court systems. Professionals in those systems must understand the elevated risk of homicide-suicide. For example, survivor advisory councils at the local, state, and federal levels create opportunities for the people most impacted to educate diverse stakeholders. 
2. Policies that create time and space between a person experiencing a crisis and their firearm, which can prevent a moment of despair from becoming an irreversible tragedy. Policies and practices including secure firearm storage in the home, giving the keys or combination to the storage device to a trusted friend or family member, or storing guns outside of the home during a period of crisis can help mitigate the risks of firearm suicide or other tragic actions.
3. Intervention through DVROs and ERPOs. The focus groups offered a landscape of risk and warning signs relevant to DVROs and ERPOs. DVROs, which under federal law prohibit abusers subject to the order from having guns, may include several other vital protections for survivors and children, including ordering the abuser to stay away from the survivor, housing protections, and child custody provisions. ERPOs are solely focused on blocking a person’s access to firearms when they pose a serious threat to themselves or others with a gun. Understanding the differences between these types of orders and the circumstances in which one or both types of orders might be appropriate is critical. Law enforcement and service providers should receive training and educational materials about both types of orders to most effectively support survivors. 
4. Screening for suicide-related behaviors of respondents in DVRO petitions. Jurisdictions should consider including questions about suicide-related behaviors of the respondent on a DVRO petition in light of the significant link between intimate partner violence, suicidal threats, and access to a gun. Most states do not currently capture information regarding suicide-related behaviors as part of the petition process. Suicide prevention and intervention resources should be shared with any respondent who demonstrates suicide-related behaviors. 
5. Disarming abusers once they are prohibited and ensuring effective implementation of laws that disarm domestic abusers. For many survivors, it takes enormous courage to seek help and interventions. When they do, they are often faced with myriad challenges, including lack of enforcement of gun safety laws. Law enforcement must safely disarm the abuser once they become prohibited from possessing firearms due to a disqualifying conviction or restraining order, and our systems must ensure that abusers are not able to purchase additional firearms. The recent Supreme Court ruling in United States v. Rahimi⁴⁴Everytown for Gun Safety, “United States v. Rahimi,” https://www.everytown.org/rahimi-scotus/.—upholding the constitutionality of the federal law prohibiting abusers subject to DVROs from possessing guns—provides a renewed call to action. States and local jurisdictions need to ensure that laws prohibiting domestic abusers from having guns and requiring prohibited abusers to turn in their guns are well implemented so that they can have their intended lifesaving impacts.

Conclusion

These focus groups showed victims, survivors, and perpetrators were navigating many layers of risk factors and protective factors leading up to these tragedies. Access to a gun was at the center of these dual tragedies. Stigma is a powerful and deadly deterrent for seeking interventions as well as support leading up to IPHS incidents. We must do more to prevent intimate partner violence and suicide. Intervention and prevention tools, like domestic violence restraining orders and extreme risk protection orders, can prevent these deadly dual tragedies. Increased awareness of risk factors across various systems can save lives. This report is dedicated to every life taken or forever changed by an act of intimate partner homicide-suicide. 

ACKNOWLEDGMENTS

Everytown for Gun Safety Support Fund would like to gratefully acknowledge the Ford Foundation for a generous grant that made this work possible and the work of Tiffany Garner, violence prevention and mental health professional, for reviewing this report.

Read the Methodological Note

• Methodological Note for Dual Tragedies: Domestic Homicide-Suicides with a Firearm Methodological Note

Help is Available

Domestic Violence Hotline

The National Domestic Violence Hotline provides free confidential support to people experiencing domestic violence and their loved ones anywhere in the US. Call 1-800-799-SAFE (7233), text “START” to 88788, or chat online at thehotline.org. You can also find more resources on domestic violence legal assistance in English and Spanish at WomensLaw.org.

988 Suicide & Crisis Lifeline

If you or someone you know is in crisis, please call or text 988, or visit 988lifeline.org/chat to chat with a counselor from the 988 Suicide & Crisis Lifeline, previously known as the National Suicide Prevention Lifeline. The 988 Suicide & Crisis Lifeline provides 24/7, free, and confidential support to people in suicidal crisis or emotional distress anywhere in the United States.

Learn how to obtain an ERPO

Extreme Risk laws have been enacted in a growing number of states. The One Thing You Can Do campaign provides an overview of the life-saving potential of extreme risk laws and aims to familiarize the general public, as well as other important stakeholders, with how they work in each state. Learn more at onethingyoucando.org.